02-105782City of Federal Way
�onmim»ry Development Services Mechanical Permit #: 02 - 105782 - 00 - ME
'
33530 1st Way S
Federal Way, WA 98003-6210
Ph: 253.661.4000 Fax: 253.661.4129 Inspection request line: 253.835.3050
Project Name: BURTON fY&
Project Address: 28808 13TH�S Parcel Number: 516210 0610
Project Description: Install fireplace insert and associated gas piping in existing residence.
Owner
Applicant
Contractor
Connie J Burton
NORTHWEST PERMIT
WASHINGTON ENERGY SERVICES CO
28808 13TH AVE S
2320 1 STAVE SUITE 250
2800 THORNDYKE AVE W
FEDERAL WAY WA 98003
SEATTLE WA 98121
SEATTLE WA 98199
(206) 282-4700
Mechanical Valuation..........................................2779 Over the Counter Permit ...................................... Yes
Mechanical Fixtures
Furnaces Number of Gas Outlets 1
PERMIT EXPIRES June 28, 2003, IF NO WORK IS STARTED.
Permit issued on December 30, 2002
I hereby certify that the above information is correct and that the construction on the above described property and
the occupancy and the use will be in accordance with the laws, rules and regulations of the State of Washington and
the City of Federal Way.
Owner or agent: Date: l , � ' ()?-�\
I tlo�/ civ
7��/a3
12/30/2002 09:23 360945BECEIVE®
40 -- .l
OEC 3 b 2002
CITY OF FEDERAL WAY
�— BUILDING DEPT.
NWPERMIT
PAGE 02
CONSTRUCTION PERMIT APPLICATION
ivy
**Tbe fo4owing ID requited irrFormation - Please paint (in ink) or typex*
Please note: Eiedticats Fife PreWenUonems And Engiteeri i
y� e� permits may rsyuire A separate appiicetioat.
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SITE ADDRESS: 28808 13TH AVE S
ASSESSOR's TAX/ PARCEL #: 5 1 6 2 1 0 0 6 1 0
LEGAL D9SCRiPTI01V OF SUB7ECT PROPERTY (ATTACH SEPARATE DESCRIPTION IF LENGTHY):
PROJECT INFORMATION _
TYPE OF PROTECT (7i11st mDPlis2tion): O BUILDING = PLUMBING )(MECHANICAL 0 DEMOLITWN
p ELMRW-AL = ENGENEERING 0 FIRE PREVENTION SYSTEM
PRUIECT DESCRIPMN (Praeidedetelied deseriptionja INSTALL FIREPLACE INSERT & PIPIN(3 TO INSERT
PROPERTY OWNER-,
CONTRACCOR:
APPtXCANT:
CONTACT PERSON
CONNIE BURTON
283 ) 9416633
2880813TH AVE
NAME iNESCU
FOR
E FROWE
(206 ) 282
4700
KUJNC ADDPZM
2800 THORNDYKE AVE W SEATTLE 98159
_
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42 i 2$
103
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?AYTIYdE PFIONE:
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MA ADDRE95 TAEEr �5S CffY, STATf„ZN)r
EkRdG PHONE:
288 13T A 5
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FAXU
i ARQIXTECT -1 TEbiaNT Z OTHER (MSCRIBE):
F• ESS
THIS PROJECT: 0 PROPERTY OWNER = APPLICANT 0 CONTRACTOR
r DET IL1-o BUILDING 7NFUi7MATION
a
PROPOSED USE.-
SPRINKLERED BUILDING?'
WATER SERVICE PRAVWM-
SEWER SERVICE PKOVMER;
EaMNG BUILDING ASSESSEDfAPPRAXSE0 VALUATION ty
_.._ PROPOSM VALUATION FOR 04MOVEMENTS;
I YES U NO FIRE 8"PPRESSION SYST M PROPOSED{RE FS Nt7
" LAKEHAVEN '1 HIGHLINE
=1 LAKEHAVEN :3 HIG"LINE
o TACOMA - PRIVATE (KNELL)
0 PRIVATE; (SSC)
12/30/2002 09:23 3609452091 NWPERMIT PAGE 01
r
**NEW RESIDENTIAL CONSTRUCTION ONLY**
NUMISFR OF DEDRQOMS: ESTIMATED SELL)I NG PRICE. �
PROJECT FLOOP ARFA5
FLOOR
BASEMENT
EXIMNG SQ. FT.
PROPOSED SQ. FT.
TOTAL --
FIRST
SECOND
THIRD
FOURTH
OTHER FLOORS (DESCRIBE)
DECK
GARAGE
HOW MANY FLOORS?
TOTAL-
YndkA'* wrumber Of each type Of fixture
MECHANICAL
AXR HANDLING UNIT(S) EVAPORATIVE COOLER(S) GAS LOG($) REFRIG. SYSTEM(S)
BBQ(5) FAN(&) —� HOOD(S) WOODSTOVE(s)
BOXER(S) Fes— FIREPLACE INSERT(5) RANGES) MISc. {
COMPRESSOR(S) FURNAM(S)
DUCT(S) GRAS PIPE OUTLET(S) NEAT SOURCE; :3 ELECTUC )(GAS
PLUMBING
BATHTUB(S) LAVA-MY(S) URMAL(S) 'WATER HEATERS)
DISHWASHER(S) _ "in WAT£kSYS. VACUUM BREAKERCS) :1 ELeCTRIC o GAS
DRMKLNG FOUNTAIN(S) SHOwER(S) WASH MA►CHIXE OUTLET
GAS PIPE OUTLET($) SximK(S) WATER CLOSET(S)
--- INTERCEPTORS) SUNP(S)
---0�5CLA1t4ER/S1GNATJJRC- BLOCK
I Cerk"Y undaf Pena" of perjury that the iMarntatlarr faltirlstoed b7 me is trUe and correct to the best of my knowiedga, an:s
further,. that I3M authorized by the owner of the abbe VMMEM to prrfario the w"k for which the Penn" appilcatian ors brads. I
further agree to bald bsranic4bS tbaa My of Federal Way as to any da6rr (ir+dudireg cysts, e�rpwm4w, and attorneys` fees incurred in the
Investigation and defense of such ciaim), which may be made by any Person, iarduding the undersigned, and filed against the CKY of
Federal Way, but only where auah rAim arises out oi' the reflaPm of the cky, (nriud ing As oftkers and employees, upon the at wmcy
Of the information supulled to the city as�rt of this application.
NAMEITITLE;DATE: I X27W
1 t PROPERTY OWNER -j APPLICANT u CONTRACTOR
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COMMUNrTY DEYELCPMENT 5ERVjCL:S • 33530 PIR4T WAY SOUTH • PO "97XB a EEpEAAL WAY, %% 98053-9718 •253-661-4000 . FAX: 253-661-4129